Balanced diet is a prerequisite for physiological pregnancy, fetal development and growth. The peculiarities of the modern lifestyle impede the formation of an optimal diet, as a result of which various nutritional disorders are widespread in pregnant women, including multihypovitaminosis and microelementosis. Micronutrient deficiencies experienced by the fetus during intrauterine development can alter body structure, the function of stem cells and regulatory hormonal axes, which increases the likelihood of developing noncommunicable diseases in adulthood. Folic acid and methylation factors, iron, zinc and magnesium have the greatest influence on fetal programming. For the prevention and correction of micronutrient deficiencies in pregnant women, an integrated approach is required using multivitamin and mineral complexes.

Insufficient provision of women of reproductive age with omega-3 polyunsaturated fatty acids (PUFA), including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), increases the risk of reproductive and somatic pathologies. The article presents the results of a cross-sectional study of Russian women of reproductive age (18–35 years old, n = 1225). The total consumption of omega-3 PUFA was very low (150 ± 99 mg/day), and the consumption of EPA and DHA was extremely low: EPA 42 ± 35 mg/day (recommended 600 mg/day), DHA 39 ± 33 mg/day (recommended 700 mg/day). Lower total intake of omega-3 PUFAs was associated with depressive syndromes (P = 0.0104), heart valve dysfunction (P = 0.0310), increased frequency of herpes infection (P = 0.0284), and insufficient intake of other micronutrients (vitamins group B, zinc, iron, selenium, vitamin A). Low consumption of EPA is associated with decreased levels of follicle-stimulating hormone (FSH) and luteinizing hormone (P = 0.0352), hyperhomocysteinemia (P = 0.0115), hyperinsulinemia (P < 0.00001), liver disease (P = 0, 0061) and with increased accumulation of cadmium, mercury and lead (P = 0.0352). Low DHA intake was associated with hyperinsulinemia (P < 0.0001), liver disease (P = 0.0370), prolonged wound healing (P = 0.0560), decreased FSH levels (P = 0.0350), chronic bronchitis (P = 0.0524), depression (P = 0.0110) and polypharmacy (P < 0.00001). The number of women regularly using EPA/DHA-based drugs did not exceed 6.5% (n = 80). Thus, the DHA/EPA subsidy is an important resource for improving the somatic and reproductive health of Russian women aged 18–35 years.

Diet features, pregnancy, gynecological and somatic diseases can have a negative impact on a woman’s supply of iron. Iron deficiency is the most common micronutrient deficiency in the world, and adolescent girls and women of reproductive age are at high risk of developing iron deficiency. Lack of iron leads to cell dysfunction, impairs physical and mental performance, and negatively affects the appearance of a woman. If iron deficiency is detected, it is necessary to adjust the diet and use dietary supplements for nutritional correction. In iron deficiency anemia it is necessary to use medicinal therapy with iron preparations, taking into account the effect of certain nutrients on iron absorption.

Menopause and aging are associated with changes in circulating gonadal steroid hormones, insulin sensitivity, body composition, also lifestyle and social coordinates. Vitamin D status influences Different metabolic adjustments, aside from calcium–phosphorus and bone metabolism. The main blood marker used to measure endogenous vitamin D status is 25-hydroxyvitamin D. Aging is associated with increases in serum parathyroid hormone and alkaline phosphatase, and a Decrease of serum calcium, phosphorus, and vitamin D metabolites. 25-hydroxyvitamin D status is also influenced by the circannual rhythm of sun irradiation. Results of clinical association studies have not correlated with intervention trials, experimental studies, and/or meta-analyses regarding the role of vitamin D on Different outcomes in women During their second half of life and the vitamin D supplementation Dose needed to improve clinical endpoints. Discordant results have been related to the method used to measure vitamin D, the studied population (i.e. sociodemographics and ethnicity), study Designs, and biases of analyses. Vitamin D supplementation with cholecalciferol or calcifediol may improve some metabolic variables and clinical outcomes in young postmenopausal and older women. Studies seem to suggest that calcifediol may have some advantages over other forms of vitamin D supplementation.

The review is devoted to the problem of choosing the optimal tactics for managing patients with endometriosis-associated pelvic pain in the context of ensuring the quality of life and maintaining fertility. Diagnosis of endometriosis by direct imaging has recently come under criticism due to the inevitable delay in making a definitive diagnosis. Surgery should not be an option for all patients with suspected endometriosis, and empirical hormone therapy is relevant, as is the task of prescribing long-term therapy to improve quality of life. Modern ideas about the pathogenesis of endometriosis, the origin of pelvic pain and the pharmacological properties of hormonal drugs, outlined in the article, make it possible to build a concept of long-term management of women with pelvic pain, precisely or presumably associated with endometriosis.

The aim of this clinical case is to highlight the importance of differential diagnosing between atypical endometrial hyperplasia (AEH) and endometrial cancer (EC). A 55-year-old woman with AEH had undergone panhysterectomy. Five years later, aching pains appeared in the left abdomen. MRI in the pelvis revealed a solid mass without a clear organ affiliation. The patient underwent laparotomy with removal of the pelvic tumor, resection of the bladder and left ureter and ureterocystostomy on the left. Histopathological examination found an endometrial adenocarcinoma. Immunostaining of primary and subsequent tumors showed a local recurrence of a previously undiagnosed endometrial adenocarcinoma. Primary tumor revealed AEH with foci of adenocarcinoma with signs of dMMR/MSI-H with mosaic reactions to PTEN, PAX2 and negative reaction to ARID1А. Recurrent tumor are moderately differentiated EC with signs of dMMR / MSI-H, a positive reaction to PTEN, a negative reaction to PAX2 and ARID1A was established.

Objective. To study the effect of a combined oral contraceptive (COC) containing 2.5 mg of nomegestrol acetate (NOMAC) and 1.5 mg of 17β-estradiol (E 2) (NOMAC-E 2) on microbiocenosis and status of the vaginal environment in women of reproductive age. Material and methods. The study involved 52 generally healthy women in need of contraception aged 18 to 49 years. The average age was 35.1 (3.9) years. Before and after 6 months of COC use the microbiocenosis, vaginal moisture and acidity (pH) have been determined, a correlation with the level of sex hormones in the blood has been performed. Results. After 6 months of using COC containing NOMAC-E 2 normal flora with a predominance of lactobacilli was determined in 50 (96.2 %) women. There was a significant increase in vaginal moisture, tendency to increase the acidity of vaginal environment has been obtained. The use of pairwise correlation method did not reveal any statistically significant relationships between the changes in pH values, vaginal moisture content and the level of sex hormones and SHBG level. Conclusion. The use of COC containing NOMAC-E 2 for 6 months does not have adversely effect on microbiocenosis and state of the vaginal environment in women of reproductive age.

Purpose of the study. A systematic analysis of the data available in the modern literature on the pathogenetic relationships of obesity and thrombophilia, the search for markers and predictors of obstetric and thrombotic complications during gestation. Material and methods. The review includes data from domestic and foreign articles found in PubMed, CyberLeninka and еLibrary on this topic, published over the past 5–10 years. Results. The possible mechanisms and pathogenetic relationship of the pro-inflammatory, prothrombotic and endocrine statuses observed in obese women in the development of obstetric and thrombotic complications are clearly presented. Conclusion. Despite a significant amount of work devoted to the study of risk factors and pathogenetic mechanisms of the development of thromboembolic complications in obese women, the problem of identifying the causes and methods for correcting disorders has not been completely resolved and requires further study. At the same time, the annually increasing percentage of women with obesity of reproductive age poses new challenges for improving methods of pregravid preparation and for the effective prevention of thrombohemorrhagic complications during pregnancy, childbirth and the postpartum period.

The present study is a randomized and controlled one evaluating the effectiveness of autologous plasma during caesarean section on the healing of a skin scar in postpartum women with a high risk of purulent-septic complications. Platelet-rich autologous plasma (PRP) has been shown to have a positive effect on wound healing and promote less keloid scarring. Repeated measures ANOVA showed statistically significant differences in wound healing by intergroup factor. The intergroup factor consisted in the use of PRP for suture treatment after cesarean section (injection of PRP into the scar area and subcutaneous tissue before suture application) in group A compared to conventional suture treatment with saline in group B. Wound healing and the condition of postoperative scars were assessed according to the wound healing scales REEDA (Redness, Ecchymosis, Discharge, Approximation) and the Vancouver VSS (Vancouver Scar Scale). Studies have shown that PRP affects improved wound healing and softer scarring (significance p ≤ 0.05).

Objective of the study. To assess the relationship between the presence of breastfeeding and the likelihood of vulvovaginitis in girls in the neutral period. Methods. The study included 176 girls aged 3–6 years (73 girls with vulvovaginitis – the main group and 103 girls without vulvovaginitis – the comparison group). The relationship between the characteristics of breastfeeding, the nutritional characteristics of the girl’s mother during pregnancy and lactation, and the likelihood of vulvovaginitis in the neutral period were evaluated. Results. Failure of a newborn to breastfeed in the delivery room increases the likelihood of developing vulvovaginitis in the neutral period by 4.16 times (95% CI: 1.41–12.26). Attaching a newborn to the breast in the delivery room reduces the risk of vulvovaginitis in girls in the neutral period by 88% (OR = 0.22; 95% CI 0.07–0.71; p = 0.011). Girls with vulvovaginitis in the neutral period at the breastfeeding stage were more often fed according to the regimen rather than on demand (p < 0.001), supplemented with water (p < 0.001), and the girls’ mothers did not have a varied diet at the stage of pregnancy and breastfeeding (p < 0.001).